Book Review : Recent Advances in the War on Cancer

Cell Wars: The Immune System’s Newest Weapons Against Cancer by Marshall Goldberg MD (Farrar Straus & Giroux: $17.95; 214 pages)

Is there anyone who has not suffered through the horrible cancer death of a loved one? Just the word cancer strikes terror in most people, and understandably so.

Despite years of research and heroic efforts of dedicated scientists, medicine has little more to offer than cut, burn and poison in its fight against the disease. Sadly, these efforts more often fail than succeed.

Yet, “I remain optimistic that within another decade, most cancers will be curable,” Marshall Goldberg tells us in “Cell Wars,” his survey of recent advances in cancer treatment, principally focusing on monoclonal antibodies.

Goldberg, a professor of medicine at Michigan State University and chief of endocrinology at Hurley Medical Center in Flint, Mich., has written eight novels in addition to his medical work, and he brings a novelist’s eye and ear to the topic at hand. His story is the story of current medical research into a horrible disease, but it is also the human story of cancer’s victims, full of pain, suffering and, sometimes, courage.

In alternating chapters, Goldberg writes of science and of people, particularly one patient of his, Jim Federline, who contracted pancreatic cancer in his early 40s and waged an unrelenting fight against it, seeking out and marshaling every frontier treatment he could persuade doctors to give him.

As Goldberg’s book progresses, its emphasis shifts from the medical story to the human story. The early part of the book explains what monoclonal antibodies are and how they work and how research progresses. While not abandoning the medical facts, the latter part of the book turns its focus to the role of the patient, which Goldberg thinks is substantial.

The Role of Emotions

“Although the extent to which a human being’s emotions can affect his bodily defenses remains unknown,” Goldberg writes, “it’s my hunch that . . . the answer will turn out to be: a great deal.”

Please don’t misunderstand. Federline did not go for quack remedies, laetrile and the like, and Goldberg is not promoting the power of positive thinking to cure organic disease. Neither the patient nor the doctor believes in nonsense. They are both grounded in reality.

But Goldberg does tell of cancer patients whose tumors have disappeared. The reasons are not clear. He thinks their attitudes were not irrelevant. Still, he writes, “Though time can often be gained for the victims of advanced solid cancers, much of it enriched by love and self-discovery, only a small proportion can be cured. Though I remain confident that medical science will soon find ways to reverse this situation, as of now the failures far outnumber the triumphs achieved by monoclonal antibodies or any other means of therapy.”

Charting a Middle Course

Goldberg’s book charts a middle course between seeing the patient as the passive recipient of therapy and the main participant in his cure. There is conflicting evidence in the medical literature about the importance of each role. Some studies indicate that happy patients do better than sad patients, while other studies show that they do not. Goldberg offers anecdotal evidence based on his own patients (a small sample size) which shows that people who help the doctor fight their cancer do better than people who resign themselves to die.

Almost all of the dust-jacket quotations on this book concentrate on the science of monoclonal antibodies, which I found the least interesting part. The subject is certainly important and may yet prove a great boon in the war against cancer, so there’s no harm in knowing what it’s all about.

But the insightful part of the book is contained in the well-wrought, well-thought-out observations of cancer by a working physician with knowledge, compassion and the ability to write. It’s a pleasure to encounter a caring doctor who can distill his very human experiences and convey them on the printed page.

Goldberg’s book shows a well-trained and sensitive mind struggling to understand disease and defeat it.